Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University Paris Cité (CRESS), Bobigny, France.
Nutrition And Cancer Research Network (NACRe Network), Jouy-en-Josas, France.
Am J Clin Nutr. 2022 Oct 6;116(4):911-919. doi: 10.1093/ajcn/nqac167.
Acrylamide is classified as a probable human carcinogen by the International Agency for Research on Cancer but epidemiologic evidence on the carcinogenicity of acrylamide from dietary sources is limited.
This study aimed to investigate the associations between dietary acrylamide and breast cancer risk in the NutriNet-Santé cohort, accounting for menopausal and hormone receptor status.
This prospective cohort study included 80,597 French females (mean ± SD age at baseline: 40.8 ± 14 y) during a mean ± SD follow-up of 8.8 ± 2.3 y. Acrylamide intake was evaluated using repeated 24-h dietary records (n ± SD = 5.5 ± 3.0), linked to a comprehensive food composition database. Associations between acrylamide intake and breast cancer risk (overall, premenopausal, and postmenopausal) were assessed by Cox hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors).
The mean ± SD dietary acrylamide intake was 30.1 ± 21.9 µg/d (main contributors: coffee, potato fries and chips, pastries, cakes, bread). During follow-up, 1016 first incident breast cancer cases were diagnosed (431 premenopausal, 585 postmenopausal). A borderline significant positive association was observed between dietary acrylamide exposure and breast cancer risk overall (HR for quartile 4 compared with 1: 1.21; 95% CI: 1.00, 1.47) and a positive association was observed with premenopausal cancer (HRQ4vs.Q1: 1.40; 95% CI: 1.04, 1.88). Restricted cubic spline analyses suggested evidence for nonlinearity of these associations, with higher HRs for intermediate (quartile 2) and high (quartile 4) exposures. Receptor-specific analyses revealed positive associations with estrogen receptor-positive breast cancer (total and premenopausal). Acrylamide intake was not associated with postmenopausal breast cancer.
Results from this large prospective cohort study suggest a positive association between dietary acrylamide and breast cancer risk, especially in premenopausal females, and provide new insights that support continued mitigation strategies to reduce the content of acrylamide in food.This trial was registered at clinicaltrials.gov as NCT03335644.
丙烯酰胺被国际癌症研究机构列为可能的人类致癌物，但关于膳食来源丙烯酰胺致癌性的流行病学证据有限。
本研究旨在探讨 NutriNet-Santé 队列中膳食丙烯酰胺与乳腺癌风险之间的关联，同时考虑到绝经和激素受体状态。
这项前瞻性队列研究纳入了 80597 名法国女性（平均基线年龄±标准差：40.8±14 岁），平均随访 8.8±2.3 年。通过重复 24 小时膳食记录（n±标准差=5.5±3.0）评估丙烯酰胺摄入量，并与综合食物成分数据库相关联。使用 Cox 危害模型评估丙烯酰胺摄入与乳腺癌风险（总体、绝经前和绝经后）之间的关联，该模型调整了已知的风险因素（社会人口统计学、人体测量学、生活方式、病史和营养因素）。
平均±标准差的膳食丙烯酰胺摄入量为 30.1±21.9 µg/d（主要来源：咖啡、薯条和薯片、糕点、蛋糕、面包）。在随访期间，诊断出 1016 例首发乳腺癌病例（431 例绝经前，585 例绝经后）。膳食丙烯酰胺暴露与总体乳腺癌风险之间存在边界显著的正相关（第 4 四分位与第 1 四分位相比：1.21；95%CI：1.00，1.47），与绝经前癌症呈正相关（四分位 4 与四分位 1 相比：1.40；95%CI：1.04，1.88）。限制性立方样条分析表明，这些关联存在非线性，中等（四分位 2）和高（四分位 4）暴露的 HR 更高。受体特异性分析显示与雌激素受体阳性乳腺癌（总体和绝经前）呈正相关。丙烯酰胺摄入与绝经后乳腺癌无关。
这项大型前瞻性队列研究的结果表明，膳食丙烯酰胺与乳腺癌风险之间存在正相关，尤其是在绝经前女性中，并且提供了新的见解，支持继续采取缓解策略来降低食物中丙烯酰胺的含量。这项试验在 clinicaltrials.gov 上注册为 NCT03335644。
